Abstract
BackgroundCoronary heart disease is the leading global cause of death, and e-health web-based programmes are effective to support patients. However, fewstudieshave reported psychological outcomes and health related quality of life (HRQoL) in Chinese populations. This study aimed to investigate the effect of an e-health web-based support programme for patients with coronary heart disease on anxiety, depression, and HRQoL across six months. MethodsThis parallel-group, randomised controlled trial was conducted in two specialist clinics in Hong Kong, China. Chinese patients with coronary heart disease, older than 18 years who were able to use computer were randomly assigned 1:1 to control or intervention groups using block randomisation. All patients received standard care, but the intervention group also received the e-health web-based support programme to promote physical activity and general health monitoring. Data was collected at baseline, 3 months, and 6 months. The outcomes were Hospital Anxiety and Depression scale (HAD) and HRQoL as measured by SF12. The data was analysed by Generalised Estimating Equations Model in SPSS (version 22.0). Ethical approval was obtained from the The Chinese University of Hong Kong and Tung Wah Eastern Hospital Ethics Committee. Signed written consent was obtained from participants. The study was registered at Clinicaltrials.gov, number NCT02350192. Findings441 eligible patients (mean age 51·34 years [SD 5·02]; 66% (291) men) with coronary artery disease were randomly assigned to either control (N=221) or intervention (N=220) groups. We found significant differences in anxiety between groups (p=0·004); anxiety was also lower over time in the intervention group (β=–0·428, p=0·03 at 3 months; β=–0·806, p<0·0001 at 6 months). We found no significant effect on depression. Regarding HRQoL, a significant difference between the control and intervention groups was seen over time (β=1·377, p=0·01 at 3 months; β=2·99, p<0·0001 at 6 months), but there was no difference between groups or interaction effect between physical and mental health components. InterpretationThe findings indicate a trend of positive psychological outcomes and HQoL in patients with coronary heart disease over 6 months, although the changes did not depend on the type of intervention given. In a future study, a booster dose or more intensive approaches to enhance the intervention effect could be recommended. FundingHealth and Medical Research Fund, Food and Health Bureau of Hong Kong
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